Dental Board of California
Licensing details for: 44749
Name: NGUYEN, PHUNG KIM
License Type: Dentist
Primary Status: Current - Active
Address of Record
2114 SENTER RD #25
SAN JOSE CA 95112
SANTA CLARA county
Map
License Relationships
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: PHUNG K NGUYEN, DDS
License/Registration Type: Additional Office Permit
License Number: 7628 Primary Status: Cancelled
Address :
100 O'CONNOR DR, STE 5
SAN JOSE CA 95128
SANTA CLARA COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: NORTH SILICON VALLEY DENTAL
License/Registration Type: Fictitious Name Permit
License Number: 2329 Primary Status: Cancelled
Address :
OFFICE OF HAO NGUYEN, DDS
113 NORTH MILPITAS BLVD
MILPITAS CA 95035
SANTA CLARA COUNTY
FNP to DDS or OMS
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Fictitious Name Permit
Name: NORTH SILICON VALLEY DENTAL
License/Registration Type: Fictitious Name Permit
License Number: 2329 Primary Status: Cancelled
Address :
OFFICE OF HAO NGUYEN, DDS
113 NORTH MILPITAS BLVD
MILPITAS CA 95035
SANTA CLARA COUNTY
New License to Old License
License/Registration Role: Old Dentist License
Related Party Role: New Dentist License
Name: NGUYEN, HAO VAN
License/Registration Type: Dentist License
License Number: 42076 Primary Status: Current - Active
Address :
4545 Georgetown Pl Ste B8
STOCKTON CA 95207-6230
SAN JOAQUIN COUNTY
New License to Old License
License/Registration Role: New Dentist License
Related Party Role: Old Dentist License
Name: NGUYEN, HAO VAN
License/Registration Type: Dentist License
License Number: 42076 Primary Status: Current - Active
Address :
4545 Georgetown Pl Ste B8
STOCKTON CA 95207-6230
SAN JOAQUIN COUNTY
